Get the free NeuroStar TMS Referral Form. PLEASE REVIEW BEFORE SUBMITTING REFERRAL

Eurostar TMS Referral Form PLEASE REVIEW BEFORE SUBMITTING REFERRAL The Eurostar TMS Therapy System is contraindicated for use in patients who have conductive, ferromagnetic, or other magnetic sensitive

How to fill out neurostar tms referral form

How to fill out neurostar tms referral form

1. Obtain a copy of the NeuroStar TMS referral form from the healthcare provider or facility.
2. Fill out the patient's personal information, including name, date of birth, address, phone number, and insurance information.
3. Provide a brief medical history for the patient, including any previous treatments for depression or other mental health conditions.
4. Have the referring healthcare provider complete their section of the form, including diagnosis and reason for referral.
5. Submit the completed form to the designated contact at the NeuroStar TMS facility for review and scheduling.

Who needs neurostar tms referral form?

1. Individuals who are suffering from treatment-resistant depression and are seeking alternative treatment options.
2. Healthcare providers who believe that their patient may benefit from Transcranial Magnetic Stimulation therapy and want to make a referral for further evaluation.

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What is neurostar tms referral form?

Neurostar TMS referral form is a document used to refer patients for Transcranial Magnetic Stimulation therapy.

Who is required to file neurostar tms referral form?

Neurostar TMS referral form is typically filled out by healthcare providers who are referring patients for TMS therapy.

How to fill out neurostar tms referral form?

To fill out the Neurostar TMS referral form, healthcare providers should include the patient's information, reason for referral, and any relevant medical history.

What is the purpose of neurostar tms referral form?

The purpose of the Neurostar TMS referral form is to provide necessary information for the TMS therapy program and ensure appropriate patient care.

What information must be reported on neurostar tms referral form?

The Neurostar TMS referral form should include patient's name, contact information, medical history, reason for referral, and any relevant test results.